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bigpharmD

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I thought some of you might find this interesting...received it via email today from ASHP...maybe Z can offer some insight but I find it amusing how the pharmacy department is often under the director of nursing or some other entity.

Dear SICP Colleagues:
A recent article in my local newspaper that caught my attention reviewed a book entitled “Experts’ Guide to Doing Things Faster.” It evidently describes 100 ways to do things in our personal lives more efficiently. I pondered why so many of us seem to be so busy all the time, feeling like we are on an unending treadmill. The book contends that many of us struggle with personal efficiency issues because, “we are trying to fit 80 pounds of stuff into a 60-pound bag.” I guess it is all a matter of what we consider to be priorities in our personal lives.

What about our professional lives? I’m sure we’ve all noticed in our careers an increasing emphasis on doing more with less and on doing things faster. Many organizations seem to have undertaken a relentless pursuit of “efficiency.” Maximizing efficiency is a desirable and worthwhile goal. However, if we are not careful we can fall prey to losing ourselves in efficiency, treating it as an end in itself and not as a means to other ends. We must never lose sight of our ultimate goal, providing quality patient care.

Our market-based economy does provide a very effective mechanism for sustaining efficient organizations and eliminating inefficient ones. Modern management principles promote the idea that everything can be understood, predicted, and optimally managed in order to increase efficiency, thereby maximizing profit, performance, and productivity.

Many of our organizations have invested in technology to increase our efficiency. We have seen an increased utilization of pharmacy technicians, thereby freeing up pharmacists to do what we are hopefully really needed for. These have dramatically increased our efficiency as pharmacists and I would contend have also increased our professional satisfaction.

However, as pharmacists I think we do in some respects have targets on our backs. We are among the highest paid professionals in our health-care organizations. With this in mind, some administrators feel it makes business sense to use fewer pharmacists while at the same time requiring that we collectively produce more.

On the surface, this seems like a fair and just expectation. After all, many consider money to be the ultimate measure of productivity. Naturally, organizations want the most work with the least expenditure of money. Likewise, it’s natural for individuals to desire the most money for the least amount of time and work.

With this in mind, how do we accurately measure what a pharmacist can safely and effectively produce? I would argue that pharmacy leaders internal to an organization should be considered the authority on what staffing levels are necessary to provide the best care to our patients. However, I have noticed that this is often not the case.

There are many “expert” consultants external to our organizations that are more than willing to advise our administrators on how many pharmacy personnel are needed to optimally provide pharmacy services in our specific organizations. Surprisingly, in organizations I have been a part of, I have never seen an outside productivity consultant recommend that more pharmacists be deployed. This is hard to understand as many quality studies investigating the economic impact of clinical pharmacy services have shown a significant return on investment in reduced costs and better outcomes.

The use of what I consider to be flawed productivity benchmarks often puts added pressure on pharmacists as we try to operate at unreasonable staffing levels while trying to maintain quality outcomes. I feel these flawed benchmarks can potentially compromise patient safety. They definitely can reduce professional satisfaction.

We should all strive to optimize our efficiency and be good stewards of our limited resources. The use of productivity measurement systems can assist us in doing this, but we need to compare our operations with valid and relevant benchmark statistics. We must also never lose sight of the fact that there are definite limits to how efficient we can become and still take the necessary time required to think and to interact with patients.

I feel this issue represents a significant challenge to health-system pharmacy practice. I hope to work with other ASHP Sections to address what I consider to be the inappropriate use of pharmacy productivity benchmarks by external consultant groups.
Sincerely,
Randy Kuiper
Chair, Section of Inpatient Care Practitioners

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This dude that graduated at the same time as me just started to work evenings and weekends by himself with no other pharmacist. He basically needed 9 months of "training" until the director thought he was ready to do it on his own. Dude worked about 4 of those shifts...then he resigned just yesterday. He got so stressed out by the pace and "efficiency" of our hospital that it gave him an ulcer. I think he's going to go do mail order. Member of Rho Chi at Pitt...lmoa...

But I dunno...I'm thinking that we are already dangerously "efficient". On weekends and evenings I'm literally there alone with one technician...taking care of 130-180 patients. If stress effected me as it did the poor chap above, I'd probably be on Xanax by now. The only hospitals that are adequately staffed are huge academic hospitals that appear to enjoy throwing money into the wind.
 
:smuggrin:

Randy, Randy, Randy..... don't broadcast to the world that you really have no idea...

That's what he just did. If his department was doing well, hospital admin would not have brought in consultants. We provide consulting yet we're little different. Consultants come in, identify what's wrong and what needs to be fixed...they don't necessarily tell you how to fix it. We actually implement what we propose.

Here is how consultants work..

Consultant: Thank you mr. Admin... I'm here to assess your pharmacy. What do you think is lacking from the pharmacy and what would you like to see? Oh BTW, you'll see a bill for $15,000.

Admin: Well...Consultant... I think the pharmacists should be more visible...provide more clinical service, reduce cost, and decrease staffing.

Week later.

Consultant: Mr. Admin..here is the report.. but let me summarize it for you.. your pharmacists aren't visible.... they need to get out more...and provide more clinical service...that'll reduce cost. And you need to decrease staffing.. Thank you...here is the bill.

Admin: Great work... I have a friend who's CEO at another hospital...I know they could use your service!! Let's go out to dinner.


FYI... over 90% of pharmacy departments we assess are extremely inefficient led by DOP who has no clue. Like Randy.
 
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:smuggrin:

Randy, Randy, Randy..... don't broadcast to the world that you really have no idea...

That's what he just did. If his department was doing well, hospital admin would not have brought in consultants. We provide consulting yet we're little different. Consultants come in, identify what's wrong and what needs to be fixed...they don't necessarily tell you how to fix it. We actually implement what we propose.

Here is how consultants work..

Consultant: Thank you mr. Admin... I'm here to assess your pharmacy. What do you think is lacking from the pharmacy and what would you like to see? Oh BTW, you'll see a bill for $15,000.

Admin: Well...Consultant... I think the pharmacists should be more visible...provide more clinical service, reduce cost, and decrease staffing.

Week later.

Consultant: Mr. Admin..here is the report.. but let me summarize it for you.. your pharmacists aren't visible.... they need to get out more...and provide more clinical service...that'll reduce cost. And you need to decrease staffing.. Thank you...here is the bill.

Admin: Great work... I have a friend who's CEO at another hospital...I know they could use your service!! Let's go out to dinner.


FYI... over 90% of pharmacy departments we assess are extremely inefficient led by DOP who has no clue. Like Randy.

Yeah...but how many of your staff pharmacists spend their entire shift irate and are too rushed to make sound decisions? Whenever a management type says the words "more efficient", I cringe. I think about that poor guy in Ohio that is going to jail for a mistake that was probably made because he was too rushed.
 
Z ..i love you man....at least you have a pharmacy background...my current hospital brought in some accoutants or some shizz to assess the department...WTF...they didnt even know what a pharmacist was
 
Yeah...but how many of your staff pharmacists spend their entire shift irate and are too rushed to make sound decisions? Whenever a management type says the words "more efficient", I cringe. I think about that poor guy in Ohio that is going to jail for a mistake that was probably made because he was too rushed.

Totally agree...we are riding a fine line as well...the bad thing is it takes someone dying to get change
 
Z ..i love you man....at least you have a pharmacy background...my current hospital brought in some accoutants or some shizz to assess the department...WTF...they didnt even know what a pharmacist was

:smuggrin:

You're screwed. Well, not you...but your department. Y'all should've called us. We're the buffer between the admin and the pharmacy. We show the admin what a great job you're doing therefore you need more staff.

Here is your DOPs problem. Do he/she provide a monthly report to admin on how much money (real money..not the soft dollar of how much you saved by preventing an ADR) the pharmacy department saved? Does he/she share the financial goals with the department? Do you have a target? Do you have a baseline cost for every category of drugs based on purchase and utilization and do you have goals and do you track it monthly and try to improve? I'm going to guess, No...

Your montly financials from the business office with a Actual/budget doesn't count.

Your department is especially screwed if the accountants are using the HCA staffing model as the benchmark.. :smuggrin:
 
Yeah...but how many of your staff pharmacists spend their entire shift irate and are too rushed to make sound decisions? Whenever a management type says the words "more efficient", I cringe. I think about that poor guy in Ohio that is going to jail for a mistake that was probably made because he was too rushed.

Our goal is to have pharmacist on every floor taking care of 25 to 50 patients.. working from nursing unit..not in the central pharmacy.

So, if our staff is irate and rushed, then we'd approach the admin and say you're going to kill someone. Send help. We're pharmacists man. We take care of other pharmacists.
 
This dude that graduated at the same time as me just started to work evenings and weekends by himself with no other pharmacist. He basically needed 9 months of "training" until the director thought he was ready to do it on his own. Dude worked about 4 of those shifts...then he resigned just yesterday. He got so stressed out by the pace and "efficiency" of our hospital that it gave him an ulcer. I think he's going to go do mail order. Member of Rho Chi at Pitt...lmoa...

But I dunno...I'm thinking that we are already dangerously "efficient". On weekends and evenings I'm literally there alone with one technician...taking care of 130-180 patients. If stress effected me as it did the poor chap above, I'd probably be on Xanax by now. The only hospitals that are adequately staffed are huge academic hospitals that appear to enjoy throwing money into the wind.

Didn't we establish that people with higher grades are better workers? :smuggrin:
 
Our goal is to have pharmacist on every floor taking care of 25 to 50 patients.. working from nursing unit..not in the central pharmacy.

So, if our staff is irate and rushed, then we'd approach the admin and say you're going to kill someone. Send help. We're pharmacists man. We take care of other pharmacists.

Then call the sumbitches at my joint. Some nights I really do feel like I'm going to kill someone. Though I haven't yet. The worst I've done is put in a lovenox 40 daily when the patient was already on hep 5k and forgot to d/c the hep...and even that landed me in the princip...er I mean director's office for a good scolding.

I also forgot to mention...and this will make you lol...I am also responsible for all employee prescriptions called in or brought in during the weekends, too. So imagine you are sitting there...15 admissions needing to be entered in...each patient with a home med sheet 30 drugs deep...the daily IV round needs checked (a 30-45 minute job in and of itself.)...the pyxises all need to be filled...narcotics need grabbed out of the narc vault...

...and in comes 15 people with prescriptions for random crap...

It may be the most frustrated with anything I've ever been...with the exception of the school I graduated from...of course...

...but the kicker is that management from the director to the CEO seems to think that this is perfectly fine. They are oblivious to reality. I dunno...it seems like management types forget what its like to be a staffer...or in bpD's case with those consultants, they have never even known.

It's 6 hours on eggshells...until the overlap evening pharmacist comes in and you can get some relief from the isolation...

But, hey, it's still better than retail.
 
There are many pharmacy departments reporting to VP of Patient Care or VP of Clinical Services, glorified terms for DON - director of nursing. About 50% of the hospitals I'm invovled with.

And this really depends on the personality of the VP.. More often than not, female RN VPs are harder to work for. More detail oriented, nitpicky, and demanding than their male counterparts. Sexist statement? Yes, be it as it may. But it's what it is.

I've always enjoyed reporting directly to CEO, COO, or CFO...

The hardest administrator report to is another pharmacist.
 
There are many pharmacy departments reporting to VP of Patient Care or VP of Clinical Services, glorified terms for DON - director of nursing. About 50% of the hospitals I'm invovled with.

And this really depends on the personality of the VP.. More often than not, female RN VPs are harder to work for. More detail oriented, nitpicky, and demanding than their male counterparts. Sexist statement? Yes, be it as it may. But it's what it is.
.

Sounds like my place...
 
Then call the sumbitches at my joint. Some nights I really do feel like I'm going to kill someone. Though I haven't yet. The worst I've done is put in a lovenox 40 daily when the patient was already on hep 5k and forgot to d/c the hep...and even that landed me in the princip...er I mean director's office for a good scolding.

This is what I'd have told you... "dude.. I've made the same mistake before..probably more than you... but the patient didn't die... now get out of my office."

I also forgot to mention...and this will make you lol...I am also responsible for all employee prescriptions called in or brought in during the weekends, too. So imagine you are sitting there...15 admissions needing to be entered in...each patient with a home med sheet 30 drugs deep...the daily IV round needs checked (a 30-45 minute job in and of itself.)...the pyxises all need to be filled...narcotics need grabbed out of the narc vault

...and in comes 15 people with prescriptions for random crap...

It may be the most frustrated with anything I've ever been...with the exception of the school I graduated from...of course...

Oh hell no... employee scripts should only be called in and dispensed during "normal business" hours. I'd done quit that job by now... we had a sweet deal in my area...staff $50 per hour..M-F no holiday no weekend.


...but the kicker is that management from the director to the CEO seems to think that this is perfectly fine. They are oblivious to reality. I dunno...it seems like management types forget what its like to be a staffer...or in bpD's case with those consultants, they have never even known.

It's 6 hours on eggshells...until the overlap evening pharmacist comes in and you can get some relief from the isolation...

This during graveyard?

But, hey, it's still better than retail.

No doubt about it.

btw... Over 100 patients, I'd have 2 pharmacists during evening...
 
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this is a great 3 man discussion
 
just sayin...could be WVU some day after his MBA
 
yeah they had no clue we had to justify our jobs
 
Oh hell no... employee scripts should only be called in and dispensed during "normal business" hours. I'd done quit that job by now... we had a sweet deal in my area...staff $50 per hour..M-F no holiday no weekend.

WTF? Seriously? Got any more of that? And can you find my wife a job, too. We are having a hell of a time finding two jobs in the same area...


And about the employee scripts...they have no prescription coverage, so they pretty much HAVE TO get drugs filled at our pharmacy. Lame. Anyway, that's why they are 24 hours with the outpatient ****.
This during graveyard?

Nope, weekends. From 7AM-1PM when the other pharmacist comes in. If its a pharmacist that works 8s, they don't come in until 2PM.



btw... Over 100 patients, I'd have 2 pharmacists during evening...

Well...I do days on weekends by myself for 6-7 hours covering on average 140 patients. Do I get a cookie or some ****?
 
WTF? Seriously? Got any more of that? And can you find my wife a job, too. We are having a hell of a time finding two jobs in the same area...

yeah..we got 2 DOP positions just opened up... and I like that area.. yeah..that staff position, we couldn't fill for months...I think we're taking on a new grad but it's in God's country down the street from Caver.

You need to email our recruiter and tell them your situation and send both of your CV/Resume in... You have the link. Get off your arse and do it.


And about the employee scripts...they have no prescription coverage, so they pretty much HAVE TO get drugs filled at our pharmacy. Lame. Anyway, that's why they are 24 hours with the outpatient ****.

That's BS. It should only be done during normal business hours.


Nope, weekends. From 7AM-1PM when the other pharmacist comes in. If its a pharmacist that works 8s, they don't come in until 2PM.

with the census you have, you need 2 pharmacists.





Well...I do days on weekends by myself for 6-7 hours covering on average 140 patients. Do I get a cookie or some ****?

That's wrong.
 
yeah..we got 2 DOP positions just opened up... and I like that area.. yeah..that staff position, we couldn't fill for months...I think we're taking on a new grad but it's in God's country down the street from Caver.

As long as I'm within a 45 minute drive from a D&B, I'm gold. I'm not sure when she will graduate though. She got a nasty eye infection and she has to make up *1* rotation...which the school hasn't scheduled yet...because they hate me...

You need to email our recruiter and tell them your situation and send both of your CV/Resume in... You have the link. Get off your arse and do it.

If I mail them my CV, they will run away from it like its a nuclear device about to explode. I may have the most unimpressive CV in the history of CVs. Sub 3.0 GPA...no clubs...no awards...took 5 years to graduate. Can I put you down as a reference? Maybe that'd help...or maybe it would make them run away faster.

That's BS. It should only be done during normal business hours.

What if a person comes in Friday night with an antibiotic and/or pain med script? Do I tell them to wait until Monday? This is the sad reality of working in BFE where you are literally >90% medicare/medicaid. There isn't enough money to go around...understaffed...underresourced. At least I'm learning a lot thanks to the built in sink or swim thing they got going on.

with the census you have, you need 2 pharmacists.

Without a doubt...but you're trying to get blood from a stone. There is no money to hire another RPH...or so we are told...

That's wrong.

lol...
 
I looked at your openings...I saw Minneapolis and got all excited...then I saw that it's a lame outpatient pharmacy job...wtf...you guys are in the business of script jockeying now?

You guys got anything not listed on the site? There are only like 6 staff openings listed...
 
Aint no one is going to ask you for your GPA. Forget CV...do a resume and list all the stuff you're doing now and all the things you know how...like your pharmacy operating sysem..Cerner, Meditch or whatever.

You haven't mastered the art of dressing up a resume yet have you. And for references, just put in available upon request. Contact our recruiter and say you're a package deal and tell them the area you're interested in. So at least we'll have you in the file. Things happen randomly and something can pop up any day.
 
I looked at your openings...I saw Minneapolis and got all excited...then I saw that it's a lame outpatient pharmacy job...wtf...you guys are in the business of script jockeying now?

You guys got anything not listed on the site? There are only like 6 staff openings listed...


LOL... stay away from that one.

We do have openings that may not be listed...you just never know. We've hired brand new grad for DOP before... and it's worked out well. Heck..we're interviewing a brand new grad for a DOP now..not sure you want to live there...but you never know.
 
too bad I'm late to the party! I have to say that I agree with most of what the sausage fest had to say.
 
bump


what web site are we talking about?

wife just got offered 3 different hospital jobs in the city we are moving to after my residency....all sweet jobs....interviewed at all 3 in one day and given the job the next day.....saturation my a#$
 
Then call the sumbitches at my joint. Some nights I really do feel like I'm going to kill someone. Though I haven't yet. The worst I've done is put in a lovenox 40 daily when the patient was already on hep 5k and forgot to d/c the hep...and even that landed me in the princip...er I mean director's office for a good scolding.

I also forgot to mention...and this will make you lol...I am also responsible for all employee prescriptions called in or brought in during the weekends, too. So imagine you are sitting there...15 admissions needing to be entered in...each patient with a home med sheet 30 drugs deep...the daily IV round needs checked (a 30-45 minute job in and of itself.)...the pyxises all need to be filled...narcotics need grabbed out of the narc vault...

...and in comes 15 people with prescriptions for random crap...

It may be the most frustrated with anything I've ever been...with the exception of the school I graduated from...of course...

...but the kicker is that management from the director to the CEO seems to think that this is perfectly fine. They are oblivious to reality. I dunno...it seems like management types forget what its like to be a staffer...or in bpD's case with those consultants, they have never even known.

It's 6 hours on eggshells...until the overlap evening pharmacist comes in and you can get some relief from the isolation...

But, hey, it's still better than retail.

It is? Hmmmmm, I say it sounds just like retail only with a 100 times gretaer chance you will kill someone.

But hey who am I....If it makes you happy.
 
What website are you guys talking about? Share the address please!
 
people need to be better stalkers!

I've actually caught sight of the man!
 
bump


what web site are we talking about?

wife just got offered 3 different hospital jobs in the city we are moving to after my residency....all sweet jobs....interviewed at all 3 in one day and given the job the next day.....saturation my a#$

the hell city are you moving too? I'm having a hell of a time here...
 
best city in the midwest

Wow, man...I brought up some of the local hospitals in said town...every dang one of them is looking for pharmacists. Thanks...that's a definate backup plan right there...because its better than my other backup plans...Cleveland and Detroit. :scared:

If you don't mind me asking...could you PM me what the going pay rate is there?
 
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